Elderly urged to study
new drug benefits

Medicare recipients can join
the discount plan in November

Medicare recipients in Hawaii are being urged to learn about new prescription drug benefits they can start applying for in November.

Drug benefit countdown begins Key dates for Medicare recipients who might be eligible for prescription drug benefits under a new law that takes effect Jan. 1: June: People with Medicare and Medicaid should watch for a letter from Medicare notifying them of new prescription drug coverage. October: Scheduled completion date for prescription drug plans to be offered by private companies under Medicare. Nov. 15: Recipients can start enrolling in the new prescription drug plans. Jan. 1: Prescription drug coverage begins for qualified applicants. May 15: Open enrollment ends for the Medicare prescription drug plans. Late enrollment charges could apply.

"There's a lot of changes and a lot of information out there, and it can get pretty cumbersome pretty quickly," said Anna Schwamlein, a Washington, D.C.-based representative from seniors advocacy group AARP.

Schwamlein was in Hawaii this week for a series of statewide public forums sponsored by AARP to educate people on the upcoming changes to Medicare benefits and answer questions on proposed changes to Social Security. U.S. Reps. Neil Abercrombie and Ed Case also attended to address seniors' concerns.

The additional prescription drug benefits, known as Medicare Part D, are voluntary and take effect Jan. 1. They were approved by Congress in 2003 under the Medicare Modernization Act.

The law allows private companies to provide inexpensive prescription drug plans for Medicare recipients who meet a certain income and asset level.

The exact amounts for the plans are not yet known. The federal Centers for Medicare and Medicaid Services, which administers the programs, is working out final details of the plans that are scheduled to be completed in October, Schwamlein said.

Premiums are expected to be about $35 a month in the first year of the program, with a deductible around $250. Medicare would cover 75 percent of drug costs up to $2,250, which amounts to $1,500 after the $250 deductible.

Once a participant's out-of-pocket drug costs reached $3,600, not including premiums, Medicare would start paying again. The most any participant would pay in a year would be $5,100.

Medicare would pay 95 percent of drug costs over $5,100, known as catastrophic benefit, with a $2 co-pay for generic drugs and $5 for name-brand medication.

"Unfortunately, this involves a lot of numbers," Schwamlein said. "I think people have a lot of questions. Some of the questions we can't answer right now because we don't know what the plans are going to be until October.

"What we do know is there are going to be plans offered in every state."

The first enrollment period for the program runs from Nov. 15 through May 15.

Schwamlein said Medicare recipients should expect to receive information from AARP, the Social Security Administration, the Centers for Medicare and Medicaid Services and other groups notifying them of the new benefits.

Low-income Medicare recipients might qualify for additional benefits. Those recipients should expect a letter from the Social Security Administration in the coming months explaining the application process.

About 19 million such letters are being mailed nationwide, with about 99,600 going to Hawaii residents, AARP said.

Schwamlein urged Medicare recipients to watch for all mailings and learn about the new benefits.

"They will have seven months, from November 15th through May 15th, to sit down with AARP's information, with Medicare's information, with the various information from the different plans," she said. "They'll be able to sit there and they'll be able to say, 'OK, I've got all my information in front of me, let me see what choice I can make.'"

AARP public forums already were held on Maui and Oahu. The final meetings are:

» 8 a.m. today, Sheraton Keauhou, Kona.
» 5:30 p.m. today, Terrace Restaurant at the Kauai Lagoons, Kauai.
» 2 p.m., tomorrow, Uncle Mikey's, Hilo.